Knee bother and University

I have fluid on my left knee… That is not a good sign at all. Thankfully it isn’t too swollen or too painful and one of the benefits of doing Physiotherapy as a degree is that I have access to professional physiotherapists, some of whom have worked in the field of Rheumatology, and who can give me advice. BUT… and it is a big but, I need to feel comfortable about sharing my condition with the people I work with. I have a massive internal battle going on about how professional it is to share my health with my teachers, and although sometimes it is unavoidable, I really do try to keep my condition as separate from my working life as I can.

Only 2 of my lecturers know about my condition, and both times it took real guts to tell them. I am so used to hiding my condition from people, and avoiding talking about it. I am really good at shutting down questions if I don’t want to talk about it, and although I am always happy to answer questions about my condition to raise awareness, I always try to give a general answer rather than using what has happened to me as an example [although this predominately happens when I am talking to someone face to face, I am good at sharing things when I don’t have to see a person’s reaction, and I am also good at talking about issues with people who are going through the same things I am]… For instance I might tell of how people I know have faced some difficulties rather than saying exactly what I have been dealing with. However, since I have gauged the reactions of people as generally supportive I think that I might start coming out of my shell a bit when people ask me questions face to face.

The first lecturer I told happens to be the Head of the Physio department at my uni and was incredibly supportive. She told me that as long as I felt that I could cope with what was going on, she was totally fine with it. And as soon as I feel that I am not coping so well, that I should come and speak to her and we will get occupational health involved. She also told me to keep her informed about what is going on and she was genuinely caring towards me.  The second lecturer found out kind of by accident. As you all know I have had issues with the ligaments in my knees for well over a year now , approaching the year and a half mark, and I still haven’t had many answers about it. I still didn’t know if it was related to my autoimmune condition [although we have suspected it was]. We were doing a practical session on the knee and so I figured I would ask whether he knew what it was, and any exercises/stretches I could do to help them. Again, he was totally understanding and listened to me explain how I have no idea what happened but the ligaments [LCL and MCL] in my knees have been sore for well over a year and did he know anything that could help. The first thing that he asked me what if I have autoimmune arthritis, or a family history of RA… That hit me like a brick, I wasn’t expecting anything like that. He pretty much hit the nail on the head within 30 seconds of me asking the question… something that every other health care professional I have seen over the last 8 YEARS have only just been able to figure out. I explained to him about my diagnosis, and told him about the morning stiffness, which on that particular day was 3 hours, and asked that because it was most likely autoimmune related was there nothing we could do to treat it… My lecturer was then nice enough to give me a good 30 minutes of his time and explain all the different exercises that I could do to help different muscle groups in my upper legs so that we can reduce any patella mal-tracking and basically increase the strength of the muscles in my legs to try and reduce any problems I might get in the future. The only problem is that I haven’t been able to do the most beneficial exercises on my left leg because of my knee…

Which brings us back to the fluid on my knee. As part of the assessment that we were taught to do on knees we had to learn how to test for fluid on the knee… usually done by 2 special tests, one called the patella tap [where you brush the fluid down from the upper leg into the knee and tap on the patella, if the patella bounces back up then there is fluid in the knee, if not it means that the patella is resting against the femur where it should be] and the bulge sign, where you brush the fluid away from the inside of the knee then brush down the outside of the knee and if you see a bulge appear on the inside of the knee then there is fluid on the knee. [Note: there are other special tests but these are the ones we mainly focused on]. When we were practicing these in class mine were negative… no fluid in the knees! However the other day when we were practicing them for out exam, my right knee was negative [wooo!!!] but the poor left knee was positive… I had a positive patella tap in my knee [Note: we didn’t try the bulge test]. We repeated this a few times to check but it was definitely positive. On the bright side, at least I know what a positive patella tap looks like.

On Monday I will have been taking Plaquenil [AKA Hydroxychloroquine] for 13 weeks, I was told it should be working by the 12th week but that hasn’t really happened. My morning stiffness is bouncing around all over the place, from as little as 1 hour, all the way up to 6 hours… And I am getting stiff when I am sitting down too long. Most of my lecturers are 2 hours long and I can’t stay sitting for that long, it’s too painful. I have taken to leaving the lecture once an hour to “go to the toilet”, in other words to stretch my legs… but that means that I have to try and sit at the end of rows and nearer the front so not to disturb everyone… It’s difficult sometimes. A lot of my friend’s on instagram have been telling me not to give up on Plaquenil, as I was feeling quite disheartened that it wasn’t working as well as I had hoped. Some of them found that it took longer than 12 weeks for plaquenil to kick in, and other people found that when they came off it they found that it had been helping but it was a gradual improvement, so gradual that they hadn’t really realised until they came off of it. So I am hopeful that I am one of those people!

On Wednesday I am headed back down to my rheumatologist’s office to see a podiatrist who specialises in Rheumatology. The thought was that he could maybe help with new insoles to help with the achilles tendonitis which has been on-going for a good 3 or 4 months now, although thankfully it is quite mild right now. And then in March I see my Rheumy again and we decide where to go with the treatment.

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